- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.70 / $958.19 / $8,413.00
| Facility | | $603.70 | $958.19 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,094.75 / $2,094.75 / $2,993.14
| Facility | | $2,094.75 | $2,094.75 | $2,993.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.70 / $794.73 / $1,210.31
| Facility | | $603.70 | $794.73 | $1,210.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,351.64 / $8,957.00 / $26,542.00
| Facility | | $2,351.64 | $8,957.00 | $26,542.00 |